Cover Image

Cutaneous necrotizing vasculitis as a first manifestation of antiphospholipid syndrome with catastrophic development

Lucia Todaro, Angela Luppino, Renata Carra, Aldo Nocchiero, Anna Maria Marson, Egidio Genovese, Federico Ragazzoni, Roberto Quadri
  • Angela Luppino
    Division of Internal Medicine, Ospedale Civico (ASLTO4), Chivasso (TO), Italy
  • Renata Carra
    Division of Internal Medicine, Ospedale Civico (ASLTO4), Chivasso (TO), Italy
  • Aldo Nocchiero
    Division of Neurology, Ospedale Civico, Chivasso (ASLTO4), Chivasso (TO), Italy
  • Anna Maria Marson
    Division of Neurology, Ospedale Civico, Chivasso (ASLTO4), Chivasso (TO), Italy
  • Egidio Genovese
    Neuroradiology Unit, Clinica Eporediese, Ivrea (TO), Italy
  • Federico Ragazzoni
    Division of Internal Medicine, Ospedale Civico (ASLTO4), Chivasso (TO), Italy
  • Roberto Quadri
    Division of Internal Medicine, Ospedale Civico (ASLTO4), Chivasso (TO), Italy

Abstract

We describe a case of anti-phospholipid syndrome, with catastrophic development and unusual brain involvement, in which the first manifestation was necrotizing cutaneous vasculitis. A 58-year-old woman presented with fever, gangrene of her lower limbs and ischemic lesions of her arms and hands. Laboratory results showed normal white cell count and normal procalcitonin value. The vascular ultrasound study of the lower limbs did not show any thrombosis or stenosis. A chest-abdomen computed tomography scan showed inflammatory thickening of the lung. A month after admission she developed confusion, weakness and aphasia. Magnetic resonance imaging of the brain showed hyperintense bilateral symmetrical lesions in the frontal and cerebellar regions. Anti-cardiolipin antibodies and lupus anticoagulant were negative, whereas anti-β 2 glycoprotein 1 were in high titer. She was started on steroids, and subsequently warfarin, acetylsalicylic acid and hydroxychloroquine, with progressive improvement of her clinical status.

Keywords

Vasculitis; antiphospholipid syndrome; cutaneous necrosis.

Full Text

PDF
HTML
Submitted: 2016-03-06 08:56:06
Published: 2017-06-14 12:04:08
Search for citations in Google Scholar
Related articles: Google Scholar
Abstract views:
45

Views:
PDF
21
HTML
3

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


Copyright (c) 2017 Lucia Todaro, Angela Luppino, Renata Carra, Aldo Nocchiero, Anna Maria Marson, Egidio Genovese, Federico Ragazzoni, Roberto Quadri

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
 
© PAGEPress 2008-2017     -     PAGEPress is a registered trademark property of PAGEPress srl, Italy.     -     VAT: IT02125780185